tag:blogger.com,1999:blog-7772182113499451603.post4528378636343981617..comments2024-03-27T10:50:53.692-05:00Comments on Real Psychiatry: kappa statistic rhetoricGeorge Dawson, MD, DFAPAhttp://www.blogger.com/profile/03474899831557543486noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-7772182113499451603.post-58638795041089044902013-04-03T13:18:28.074-05:002013-04-03T13:18:28.074-05:00Hello!
"The Neuroskeptic himself seems to be...Hello!<br /><br /><i>"The Neuroskeptic himself seems to be slighlty more tolerant but like most bloggers he has to stir the pot."</i><br /><br />Actually I'm very tolerant of psychiatry - when the evidence supports it. I wrote <a href="http://blogs.discovermagazine.com/neuroskeptic/2012/12/22/when-mental-illness-isnt/" rel="nofollow">this post</a> which made a lot of anti-psychiatry readers furious.<br /><br />I'm on your side. I just don't think DSM-5 is on our side.Neuroskeptichttps://www.blogger.com/profile/06647064768789308157noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-3181450245257288252013-02-11T12:39:47.318-06:002013-02-11T12:39:47.318-06:00While I admire your rhetoric - what you say is not...While I admire your rhetoric - what you say is not true. Let me give you a basic example of back pain. How many people do you think are on maintenance NSAIDs for chronic pain or back pain and how much damage do you think is caused by this practice in terms of GI bleeds and kidney disease? The study has not been done yet, but I think that it would not be surprising to find that duloxetine was a better treatment that eliminated these risks. It is always surprising when I hear about "lower risk non-invasive treatments" when treatments like NSAIDs far exceed the risk involved from most psychiatric medications. On your point about ethical code, when I practiced geriatrics, it was my job to simplify unmanageable lists of medication - 90% of those drugs were not psychiatric. The geriatrics literature is full of examples of polypharmacy in geriatrics patients including psychiatric medications prescribed by primary care physicians for questionable indications. Ethical and philosophical arguments about the superiority of other practitioners are as rhetorical as the kappa statistic application. You have obviously never been misdiagnosed by a primary care physician or a surgeon. George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-22159877772161868222013-02-11T12:10:37.480-06:002013-02-11T12:10:37.480-06:00As I've posted elsewhere regarding comparisons...As I've posted elsewhere regarding comparisons between psychiatry and medical disciplines:<br /><br />Among the differences, first and foremost, physicians treating a medical disease can tell when to discontinue drug therapy for lack of benefit. Second, their ethical code recommends trying lower-risk, preferably non-invasive treatments first before ratcheting up the risk level.<br /><br />Psychiatry follows neither of these practices, and because of so much bad research, clinical risk-benefit assessment of medication for an individual patient is arbitrary.<br /><br />In psychiatry, arbitrary diagnosis is followed by arbitrary treatment -- which they don't know when to stop -- with inadequate understanding of the risk-benefit situation. Consequence: Poor outcomes with lasting adverse effects that are not tracked or studied to improve patient safety.Altostratahttp://survivingantidepressants.orgnoreply@blogger.com